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30. Medical Art

In the present section I will not deal with the phenomena concerning the regulation of the nervous and psychic life and disturbances common amongst the Tungus. In connection with other questions I shall treat it later in a detailed manner in Part Four of this work. I shall now confine myself chiefly to the use of surgical methods and practical use of medicines. However, some remarks are needed before giving facts. The Tungus distinguish different groups of cases which arm usually treated in a different manner surgical intervention required by the injury of the bones, skin and soft parts of the body are considered as cases of «breaking» and «repairing», as natural as any other breaking» which may be «repaired»; surgical intervention for giving an outlet for the accumulated products of a local pathological process (various abscesses); individual slight physiological and pathological disorders; infectious diseases; the obstetrical cases; and the psychomental disturbances.

Different troubles requiring intervention, according to the Tungus, may be due to accidents (breaking of tissues), to infection with the microorganisms (kulikan), to activity of the spirits, and naturally child birth. The first group does not require any special explanation. If something is «broken» it may be «repaired», so the Tungus, for instance, stop bleeding with hygroscopic materials, e. g. rotten wood, ashes etc. Yet, they may press the blood vessels above the wound. In the case of breaking bones they would fix the broken edges and strongly bind the broken limb. No essential intervention will be made in case of breaking small bones or the skull. In the case of cutting sinews of the hand the Tungus (Birarchen) kill a partridge, take out the sinews of the leg and with a piece of it connect the separated ends of the sinew fixing them with a long hair. This is a case of transplantation of tissue. With the animals (reindeer and horses) they would go still further and would carry out more complex operations, as extending the skin for covering wounds and. «repairing» the wound with the skin taken from other parts of the body, always sutured with horse or human hair. In the case of falling out of the organs due to rupture of the external covers of the abdomen, which is a common occurrence with the animals, they would put them back and sew the wound [196]. In case of hopeless wounds and breaking of the bones they would cut off the fingers, even the hands, and even other fractions of the limbs. A hot iron is used to stop the bleeding [197]. In the case of supernumerary teeth in horses the Tungus of Manchuria extract them, for the horse with such teeth is thought to be doomed to perish. However, sometimes it is impossible to carry out a successful operation. The operation of castration of the reindeer is made by biting but some disinfection and arrest of bleeding is made with hot iron. The operation of sawing antlers is carried on with the same precautions. The cases of abscesses are first diagnosed and different cases of s«welling» are distinguished. They distinguish, for instance, the swelling of the thyroids, according to the Tungus Birarchen, very common amongst the young people which is well down from the observation on other ethnical units) and characteristic of some localities amongst the adult persons especially the Dahurs. In this case they say that it is due to the water, e.g. the upper course of Sun Bira (i. e. the Sun River, a tributary of the Amur below Aigun) is particularly bad. The abscesses sometimes must be cut as soon as possible, but in some cases one must wait until the matter is accumulated. The perforation and squeezing of the matter from the abscesses is also widely practiced. In the animals it is always done. The operations on abscesses of the throat in man as well as those on the neck are done, although they are considered dangerous. In domesticated animals the Tungus also use perforation of the bowels, reached from the back, when they are filled with gas.

The idea that the diseases may be due to the microorganism has been reached through the observation of the wounds in which the worms are sometimes growing and attain a size sufficient for being visible by the naked eye. The inference made is that there were very small kulikan (worm) which could not be seen by the eye but which have gradually grown into large worms. The next idea is that there are various diseases due to the microorganisms. Here the Tungus would not agree one with another as to the causes of disease. Some of them would recognize diseases as due to infection while the others would suggest the spirits activity.

For instance, amongst the Tungus of Manchuria, smallpox as a rule is considered as a disease sent by the spirits, but they recognize that it is contagious. Therefore they are very strict in avoiding families affected by it. The owner of the house, or of the wigwam places outside a post with a piece of red cloth. The Man-chus observe the same custom. These houses cannot be entered by the outsiders. Indeed, the announcement of smallpox is considered as a custom connected with the spirits, but the Tungus act as though they know the infectious character of the disease. Therefore all Tungus groups accept with pleasure vaccination as a preventive method [198]. Chickenpox and measles are regarded in the same manner and so they are announced. As to the explanation of origin of these diseases the Tungus, as in many other cases, use Chinese theories. Amongst the Birarchen the method of vaccination has become so common that when they cannot get vaccine they take the secretion from freshly vaccinated persons. However, the Birarchen say that such a vaccine is not sufficiently effective, which they see in the fact that the process is not virulent. So in this case they become experimentalists. Hydrophobia in dogs is regarded as a special disease which may also affect man if the dog bites the man [199]. However, even if there is no wound the bitten man must carefully cut out and throw away the parts of the clothing bitten by the dog. The hydrophobia is recognized from the behavior of the dog when it stands against the wind with the hair up. No spirits are responsible here and no method of curing is known [200].

The diseases thus may be classified according to their genesis. In dependence on the diagnosis there may be chosen various methods of treatment, In the case of infection they would use all kinds of medicine and physical intervention, while in the case of spirits they would confine themselves to prayers and sacrifies. We shall see later that the shaman's activity is very limited and is chiefly confined to the psychomental disorders and only partly to the management of other spirits producing physical troubles.

The methods of curing diseases are thus varied. They use very largely the treatment with the hot springs [201], the effectiveness of which, however, may disappear in case, for instance, a woman akipchu (vide SONT), i.e. prohibited, should enter the spring [202]. They would use hot tea, hot melted fat, hot bandages etc. The Tungus materia medica, as far as I know, are not numerous and they sometimes contain the ingredients like the hair of the bear etc. which, it may be supposed, have no therapeutic effect [203]. The organs of animals are also used. However, whether they have any organotherapeutic effect or are used as «magic» methods I cannot definitely state. Together with the extension of their relations with the Russians and Chinese the Tungus have introduced several medicines of foreign origin, some of which they greatly appreciate and particularly those which produce some external and noticeable effect, such as local inflammation and irritation on the skin. Some materia medica and methods have reached the Tungus through the Mongol lamas. Amongst very numerous methods which may be conventionally called «magic» methods and which have in view the protection of man from the activity of spirits and various pathogenic agents there are some methods which may be classed so only with great reserves. Indeed, the local irritation of the skin with friction, pinching, etc. which has been known from time immemorial as a result of experiment, also from the Chinese cannot now be regarded as magic for the effect of the course of some maladies must be considered as positive. However, even in recent time these methods as distinct from those used in European medical art, and sometimes misunderstood, were regarded as pure and simple magic. The same is true of some Chinese materia medica often used in colored paper with written character on it. The attention of the observer may be attracted by the color and characters which have sometimes no intended magic function at all. Moreover, the self-suggestion stimulated by the swallowing of a paper with characters written upon it, or by swallowing a quite inoffensive medicine perhaps must be accounted as one of common positive methods of medical art. To a superficial observer they would appear to be magic as well [204].

In the case of the help to women in labor there are methods of special kinds which have already been partly described in SONT.

There are distinguished different diseases due to the infection resulting from the living together, e.g. in the villages. Amongst the Birarchen and Kumarchen they are grouped under the names of various burkan (vide infra Ch. XIII) and sometimes they are directly connected with the presence of soldiers, Mongols etc. as it is with the veneral diseases and syphilis. Yet, a series of diseases which I could identify as typhoid fever, typhus, influenza, pneumonia, pleuritis, malaria (I have never observed it amongst the Tungus) etc. altogether numbering seventy two are known under the name of ain'i burkan. Indeed, in this case burkan is not exactly the same as burkan with which the shaman can deal. In disease the Tungus take medical measures or await the end of the process. They do not understand burkan in the sense of spirits but in the sense of infectious diseases, almost like general name «influenza» which may cover the most different diseases and their causes. The ain'i burkan is especially «active» in the places where many people live together. This is the reason why the Tungus very often avoid the visiting of such places.

We have already seen that in the case of measles, smallpox, and chickenpox the Tungus use no medical intervention. They place the person affected in a separate room, when possible, or isolate in a large sleeping bag in the wigwam. They try to avoid noise, sometimes keep dark, try to make a child pleased, and from time to time make sacrifice and pray. No medicines may help. The same method is used in the case of some diseases due to ain'i burkan. This is a recognition of the impossibility of helping the sick people. One may see and hear very often discussion as to the cause of disease and kind of burkan which is responsible for it. After the experiment with the shamanistic intervention they come to the conclusion that there are other burkan which cannot be controlled by the shamans, or to the conclusion that there is a wearing out of the organism or some defect as it is e.g. in the case of some woman's troubles. The treatment is to leave alone the person affected to go through the disease with no further intervention.

Here it may be pointed out that the Tungus recognize the ageing, wearing out of the organism, which they would compare with the senescence of the animals, trees, and manufactured «unanimated» things. In their eyes this is a natural process which cannot be controlled. So that all diseases, according to them, due to old age are considered as natural phenomena in which nobody and nothing can help. In the same way they treat death, as will be seen, but it does not make it better in the eyes of the Tungus who lose the people whom they love.

Indeed, the opinions of the Tungus regarding various diseases and defectiveness of the organism are subject to the great variations both amongst the groups and amongst the individuals belonging to the same group. We have seen that in this respect the new ideas come from various sides, from the alien groups, and from their own investigation of facts, and they may be due to correct or wrong generalizations. Therefore the same pathological condition may sometimes be explained in different ways.

196. Amongst the Kumarchen a man in the state of intoxication cut his abdomen so that a part of omentum came out. He could not put it back. Next morning be carefully cut it off and sewed the wound. In a few days he recovered.

197. Amongst the Birarchen after a strong attack of a bear the man's skull was badly broken The bones were fixed as far as possible, the edges of the broken akin cut off and what remained was stretched and connected with the hair.

198. This is practiced by the wandering Chinese «doctors», and specialists, — Russian doctors and trained nurses amongst the Tungus of Transbaikalia. 199. Some Tungus believe that if the dog should bite a tree or any other unanimated thing the latter may move (Birarchen).

200. The Dahurs use a powder prepared from an insect (beetle). According to them the person bitten by the mad dog will not fall ill if this powder is used within a certain time. Amongst the Chinese, according to the Tungus, the man bitten by the dog is put in a dark room away from the sun, for one hundred days, so no disease would occur.

201. The Tungus have discovered a great number of springs in different parts of known territories and outside of their territories which they visit only for the purpose of taking cure.

202. e.g. this was the case with the hot springs near the twelve volcanoes near Mergen (vide SONT).

203. I find in my records very few facts as to this matter. In fact, I have noticed only two minerals used an laxatives, — «white stone» and «black stone» used by the females and males respectively. The same stones may be used for relieving cough, or pain in the stomach. It does not, however, mean that the Tungus do not and did not know other medicines.

204. The medical art of the last century in Europe with its bleeding on various occasions, inoffensive materia medica (aqua distillata with various syrups), septic surgery, peculiar, classification of diseases etc. would now appear as built up of the «magic» and empiric methods based upon coincidence of taking medicine and relative improvement of the health (very often not correlated at all, — post hoc propter hoc). But the medical art of our time is also far from being free from the same characters. The fashions of operating tonsils, cutting appendices, abuse of «antisepticism» without speaking of some medicines of strong effect but doubtful result, at last uncertainty in diagnosis and «naming» of diseases reveal a picture which in the eyes of further generations will appear in the same light as the medical art of the beginning of the XlXth century appears in the eyes of our contemporaries. However, the medical art of our day cannot.be described ethnographically for it will produce a storm of indignation on the part of professional and industrial groups of ignorant populations. Such an investigator will be declared as a dangerous and undesirable individual who in some way must be isolated or reduced in his social activity. This is one of the curious instances of functioning of the so called «civilized nations», and in this matter the so called «primitive peoples» are more tolerant and less conservative.

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